The Gap Trap

By: Jon Jablon, Esq. So how ‘bout those stop-loss carriers?! We work closely with some excellent carriers that look for reasons to pay claims and are a pleasure to interact with – but there are also carriers and MGUs out there that will do whatever they can to deny claims. Make sure y
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Attack on ERISA Preemption Continues…

By: Chris Aguiar, Esq. ERISA preemption seems like such a simple concept; further proof that reasonable minds can disagree.  In just the past 10 days we have received mixed messages from some of the highest courts in the country.  First it was the 8th Circuit’s unanimous pro-preemptio
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The Value of Self-Funding

MyHealthGuide Source:  The Self-Insurance Educational Foundation, Inc. (SIEF), 2014, www.SIEFOnline.org The Self-Insurance Educational Foundation, Inc. (SIEF has published The Value of Self-Funding. Self-funding is an important contributor to the financial and physical health of Ameri
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Why Plan Sponsors should be Upfront with Workers about Self-funding

By Zack Pace, Senior Vice President, CBIZ, Inc., Employee Benefit News (Full text) (EBN) Self-funded health plans don’t have health insurers, only health plan administrators. The knowledge that their employers are paying the claims of the plans dramatically changes employees ent
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TPA’s Fifth Annual Conference Shares Solutions & Strategies for Realizing Savings with Self-Funding

Appleton, WI (PRWEB) An annual conference hosted by Cypress Benefit Administrators in Las Vegas, Cypress University recently wrapped its fifth year of sharing solutions and strategies to help contain the ever-escalating costs of employee health plans. Adam Russo of the Phia Group open
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How to Proactively Manage Self-Funded Employer Health Plans Recommendations by a Hospital Legal Advisor

MyHealthGuide Source: Emily M. Scott As more patients join self-funded plans, hospitals face new challenges regarding billing and collection. The Chargemaster Challenge The increase in self-funded employer health plans has triggered an unintended consequence for hospitals with respect
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REGISTER NOW – 9/17/15 – “Phia Case Studies – When Silence is Loud and Assumptions Mean Disaster”

We’ve got the stories that will enable us all to learn from others’ mistakes, and see that “what we have here…is a failure to communicate.” As employers look to self-fund with increasing frequency, expectations that brokers, vendors, and third party admin
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Be Smart When Self-Funding

By Adam V. Russo, Esq. (As published in Thompson Information Services’ Employer’s Guide to Self-Insuring Health Benefits)   Introduction While we are seeing record growth across the country, self-funding is a topic that few are familiar with, even though many participate i
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Are Smaller Companies Poised to Self-fund Health Care?

By David McCann The percentage of U.S. workers covered by health plans that are at least partially self-funded by their employers has been rising gradually for many years, reaching 61% in 2014, compared with 44% back in 1999, according to the Kaiser Family Foundation.
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QBE Accident & Health Introduces Group Critical Illness Product for Self-Funded Employers

QBE Accident & Health, 5/26/2015 New York, NY – QBE North America’s Accident and Health division now offers one of the most comprehensive Critical Illness products on the market in a new employer-paid Group Critical Illness enhancement for its medical stop loss product. By p
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